Posts Tagged ‘FRAX’
Friday, the University of Wisconsin “The Bare Bones of Osteoporosis Care” Symposium had a lot of practical information. This included:
John Belizekian, MD summarized the latest research on HyperParathyroidism. While most of what we see is Secondary HyperParathyroidism, long term Secondary can morph into traditional Tertiary, or into a newly defined type of Primary HyperParathyroidism.
Joseph Shaker, MD explored new insights into Secondary Osteoporosis. These are separate medical conditions which cause osteoporosis and must be addressed if we are to succeed in treating the resulting osteoporosis.
Fergus McKiernan discussed the success of Vertebroplasty and Kyphoplasty – if you choose patients with the right Vertebral Fracture problems to operate on.
Dr Belizekian discussed new therapies which avoid the problems of current medications. Odanocatib, Abaloparatide, and Rososumab are all in FDA phase 3 trials and could be available within 5 years. FRAX can now incorporate TBS (Trabecular Bone Score).
I will cover these topics, along with those discussed at NOF, over the next few weeks.
Jay Ginther, MD
DXA is very good at determining Bone Mineral Density (BMD), provided you look at the images and over-read the computer. DXA alone is less good at predicting Fracture Risk. But, Fractures are what we want to avoid.
At the International Society for Clinical Densitometry (ISCD) meeting this week, we will discuss the other modalities, which supplement DXA to obtain greater accuracy. Vertebral Fracture Assessment (VFA) helps evaluate bone quality. FRAX was specifically designed to predict Fracture Risk. QCT (Quantitative Computerized Tomography) has been added in recent years as an alternative to DXA.
ISCD will discuss adding TBS (Trabecular Bone Score), Hip Structural Analysis, Hip Axis Length, and uses of Central CT. We are constantly pushing toward our goal – Prevent Fractures.
Preventing Fractures is not just DXA. Get a Complete Bone Health Evaluation.
Take Control of your future. Check your bone health.
Jay Ginther, MD
Wrong Question! What you should be managing is Fracture Risk. If you only look at Bone Mineral Density (BMD), you miss the chance to decrease Fracture Risk in the overwhelming majority of people.
85% of the women who Fracture have a DXA score of “osteopenia” or even “normal”. Keeping their bone density at “only osteopenia” does them no favor. So how can you manage Fracture Risk?
Forteo is a daily shot. That is a nuicence, but a small price to pay for the only Anabolic, the only osteoporosis medication which will increase bone mass in spongy (cancellous) bone. Diabetics give themselves a daily shot for the rest of their lives. Forteo is for only 2 years and uses a tiny insulin needle.
People worry about the warning that lab rats got Osteosarcoma after being given very high doses of Teriparatide for the equivalent of 70 human years. We have not seen this in humans, or chimps, or monkeys, or dogs. Rats have bones that grow all their lives. We do not give Forteo to growing humans, pregnant women, nursing women, persons with Paget’s Disease or unexplained elevated Alkaline Phosphatase, or persons who have had radiation to their bones.
Remember that you must take adequate Calcium, with food, spread out over 3 meals. You must take enough Vitamin D3 to be able to absorb Calcium. You must eat enough Protein for your OsteoBlasts to make new bone matrix.